Wednesday, May 4, 2011

Going into co-counseling training, I was excited to begin learning techniques to be a better listener and to better validate other people's feelings. As someone who also has been in traditional therapy, I found it interesting to learn more about how to structure an effective counseling session and how to support someone in distress.

What I did not expect to gain was insight into how I could make traditional therapy more effective as well.

Co-counseling teaches us several important basic guidelines such as confidentiality and the concept that "what's said in co-counseling stays in co-counseling." That is, the person in the role of counselor should not bring up what is said during co-counseling outside the session, or even in a future session. It makes perfect sense. If a counselor brings it up, the client may not be ready to discuss it and could be negatively triggered. The client alone should bring up a topic.

A light bulb went on in my head: If I want to talk about the tough stuff, then it is up to me.

For some reason, I had assumed that if I "should" be talking about something in counseling, my therapist would bring it up. I figured the therapist knows a lot more than I do about psychology and mental health. But, looking back, I realized that the therapist has always let me set the topic -- and often I've avoided the most painful ones.

Having control over the topic also means that I'm ultimately responsible for which wounds I heal. If I'm going to confront the worst of the worst, if I'm going to give a voice to the wounded soul so carefully locked away in darkness, it's my choice. No one is going to force me.

Many of us have been deeply hurt by people who were close to us, so it is understandably and justifiably scary to trust someone. And we should be cautious when we meet someone new or if someone is pressuring us to discuss issues before we're ready. But now I know the power for me to heal is in my hands.

In my 17 years experience counseling survivors of childhood sexual abuse and also being a survivor of sexual abuse, I have discovered the reality of how our society handles and thinks about abuse. The fact is, American society as a whole has so much distress about childhood abuse that there is little to no resource for people who have lived through it. Moreover, the general societal thinking around abuse blames the victims of abuse instead of holding society or abusers responsible. Incest in particular has a kind of archaic silence around it, leaving victims to fend for themselves in an environment that breeds shame, loneliness, and self-hatred. Failure of the tribe hits inconceivable heights when it comes to listening, believing, and supporting survivors of childhood sexual abuse through the healing process. If you think my perspective is an exaggeration, take into consideration that the recent statistic states that 1 out 3 girls and 1 out of 7 boys will be sexually abused by the age of 18. If you really wrap your head around this statistic, the implications are staggering. Something has gone terribly wrong.

I am someone who learned about co-counseling early in my abuse recovery. Through the years, I found many counselors to exchange time/attention with. I also taught groups of friends how to co-counsel and we have been supports for each other for years. If I hit a tough spot in my day, I have up to ten people I can call who are excellent counselors, who know how to counsel me on my abuse issues. I am someone who can report that healing is possible, that facing abuse is one of the hardest things a person can tackle and it is worth it. Healing the trauma of abuse clears a path for a life full of joy, creativity, and close relationships. There is huge freedom that comes from facing the feelings and patterns that get created through sexual abuse.

It is also clear to me that healing is not possible alone. We need to have a substantial group of people who understand abuse, to counsel us in loving, educated ways about the abuse. I believe this is the only way for survivors of abuse to heal fully within our culture. Having to do it alone or with one therapist for support is not good enough. There needs to be enough community and tribe for survivors to correct a broken sense of belonging, to feel part of a societal context that acknowledges that abuse is wrong and healing is possible.

Though I have had a very unusual path of healing with the help of many people through co-counseling, I still find that being a conscious survivor of abuse is very lonely in the larger context of the world and society. I still look at the patterns of our world and see abuse and trauma expressed everywhere without awareness. I see TV and media portraying the sexualization of children everyday. I am aware of child prostitution and pornography and the complete lack of caring our society demonstrates towards these atrocities. I witness sexism and patriarchy asserting themselves in most aspects of regular life, perpetuating the powerlessness of women, children, and the less privileged. I read about children bullied in schools and know that many targeted kids are already being abused at home, and the bullies themselves have clearly suffered in ways that make them act out. I personally talk to large groups of survivors who have been shamed, blamed, and rejected by therapists, friends, co-workers, and family members. Examples of societal ignorance and oppression are endless. We have barely begun to face the issue of childhood sexual abuse as a culture, and yet, we need to start with ourselves.

Co-Counseling Survivors

It is essential when counseling survivors of abuse to hold two truths:

1. This person is perfectly intact and ok. He/she is untouched by the abuse and can heal completely.2. This person has gotten very, very hurt. I need to believe them, be with them in their pain, and not try to fix it. My only job is to care, to empathize (!!!) and to believe what they are saying.

As I continue with this article, I will refer to the person who is giving attention as the counselor and the person receiving attention as the client. In co-counseling, these roles switch so that each person gets a turn to be both the client and the counselor.

Memory and Support

Most survivors find that very few people have attention for or have the ability to handle the details of their sexual abuse memories. Often, much of their life has been a dance of making their stories palatable for others if they even talk about the memories at all. Survivors end up taking care of everyone else in order to not be rejected, and this is exactly what they had to do as children. People in general get so disturbed by the reality of what happens to children that they see the survivor as too much, too intense, and too upsetting. This is how survivors get hurt after the abuse and into adulthood,as their tribe fails them far beyond the actual abuse. They get perceived as the problem and thus, have to carry the ugly, horror of what happened all alone, again.

A good counseling ally is able to help survivors work directly on memories, encouraging the client to feel free to share whatever is coming up. The counselor should let the client know, “I want to know what happened, I’m not scared of it, I can hear it.” Sometimes a counselor needs to ask several times “Do you want to tell me what happened, I really want to know” before a client will begin to let the counselor into their reality. The counselor can say, “then what happened?” when it looks as if the client is withholding the details or trying to minimize the hurt. If the counselor shows caring, alert interest, it will contradict the memory of no one caring about what happened.

The most important aspect of counseling survivors is showing empathy. Survivors of abuse are used to talking about or referring to their abuse without showing feeling in order to spare others (and themselves) from feeling the pain of what happened. Also, they are used to people having no empathy when hearing some of their story and then being told things like “it’s important to forgive” or “the past is in the past, why dredge it up?” This is very common because it is a way to quiet and silence survivors so that the listener doesn’t have to feel the pain/horror/helplessness/grief of the abuse. These reactions leave the survivor alone again and again and ultimately blame the survivor for being upset about being raped, molested, and tortured, etc. A very good way to show empathy is to say, “I am so sorry that happened to you” and mean it.

Most people have no experience holding a loving space for this level of horror and so they understandably want to shut down, shut the other person down, or run away. Being able to stay, listen, and respond means being able to resonate with your client while they display numbness, crying, raging, shaking, dissociation (leaving the body), and hiding (showing shame). If you, as the counselor feel unable to be present with this release of emotion, it means you need a session too! It means you need to be able to have your feelings about what you are hearing, about what it brings up for you from your life, or the world in general. A counselor can most likely only encourage the direction of full disclosure of memories if he/she gets sessions on whatever it brings up to listen to this kind of abuse. It is a great opportunity to mine the depths of your denial or ignorance so that you can be more awake for yourself and your clients. Even if you did not suffer the same kind of abuse, it can still bring up lots of feelings about places in your life where you were powerless, abandoned, betrayed, or left alone with terrifying feelings.

Patterns to Work With In Co-Counseling Sessions

There are distress recordings that are very common among abuse survivors. The more you counsel someone on abuse, the more you see the lies and false beliefs that get programmed through this kind of trauma. Below I have listed the false beliefs or distress recordings that commonly surface when people try to talk about abuse. The second list shows the contradictions or truths that work to undo the false programs.

Survivor of sexual abuse common distress recordings:

It's my fault this happenedI wanted it (often told by the perpetrator)I made it upI made it up because I just want attentionI'm damagedNo one wants to hear my storyI'm too muchI'm too intenseI'm too needyPeople are unsafeI'm inherently badI'm toxicI can never tell anyoneI must be crazyIt's because I was too promiscuousI'll never have a healthy relationshipIf anyone found out, they would hate meNo one would believe meI should get over it (this is a major one!!!)There is no point in dredging up the pastIt didn't affect meIt's not as bad as what happened to other peopleI'm grossI can't remember the details so I'm probably making it upI'm totally aloneNo one will ever love meI feel nothing/numb about itWho cares?I can’t trust anyoneI’ll never be safeMen are unsafeWomen are unsafeThere’s something horribly wrong with meI can’t keep myself safe

Contradictions

In co-counseling we use contradictions to help our clients release feelings. A contradiction is a statement that shakes up or calls attention to an underlying pattern. It can be done by the client or the counselor saying the opposite of the pattern, for example, someone who is feeling alone might benefit from saying “I feel so connected to everyone.” This might give the client some space to laugh, cry, or shake in response to such an opposite idea. Or if a client body language is shy as they talk about something, you might want to have them open their arms or shake their fists or say something like “I can kick anyone’s ass.” You can play with different contradictions until you find the one that really makes the client discharge feelings, it’s ok to try a few and learn about your client this way.

The below list shows possible directions you can give your client if you hear these distress recordings. These are just some ideas to help you start to think of your own contradictions. You can ask your client to say the contradiction, for example, they are talking about feeling unsafe, you can have them say out loud “in this moment I am safe” and see if that helps them to feel some emotions. You can, as the counselor say the contradiction to your client, such as “you are safe right now” and see how that feels for them. It can come from you or them and you can play with what seems the most helpful.

Contradictions are aimed to help people release some feelings, even tiny feelings, like a deep breath, or quick laugh. The person does not have to be sobbing or raging loudly to be getting some release. They could just be shaking a little or looking in your eyes and seeing you witnessing them and that could be very important. It is good to know that you don’t have to try too hard to get the person to feel, you only need to show loving interest, be present, and do your best.

Contradictions you can say or invite the client to say:

The Distress --- The Contradiction

It's my fault this happened ------- It's not my fault, I was innocentI wanted it (often told by the perpetrator) ----- I never wanted itI made it up ------ I believe myselfI made it up because I just want attention ----- I wanted love, not abuseI'm damaged ----- I did not breakNo one wants to hear my story ----- I want to tell you my story, or counselor says, "I really want to hear your story"I'm too much ----- It's safe to feel this, people around you can handle thisI'm too intense ------ It's safe to feel this, and it was that intense when it happenedI'm too needy ------ Counselor says to client, "It’s safe to need me"People are unsafe ------- Client says to counselor, "I trust you," or counselor says to client, “You can trust me” I'm inherently bad ------ I am good, or counselor can say, "I see how good you are"I'm toxic ----- I am not the abuse, or counselor can say, "I see how good you are"I can never tell anyone ------ I'm speaking up! Or counselor says, "I want to know!"I must be crazy ------ They were crazy (the perpetrator and colluders), I was never crazyIt's because I was too promiscuous ----- It's not my fault, counselor can say this too, "It wasn't your fault"I'll never have a healthy relationship ------ I can take a chance, I can love againIf anyone found out, they would hate me ----- I have allies, counselor says, "I'm so glad you are telling me, " and, "I like you more for telling me" No one would believe me ----- I have allies, counselor says, “I believe you, I totally believe you”I should get over it (this is a major one!!! )----- It takes as long as it takes, or, I have a right to my feelings, or, I guess I’m not over being raped/molested yet (this one is meant to show how valid it is to still be upset).There is no point in dredging up the past ----- The abuse still affects me, counselor says, "Let's get into it" "Let's dig deep" “Let’s dredge!”It didn't affect me ----- It hurts like hell, or, Ouch, it still hurtsIt's not as bad as other people’s experience ----- It was that bad, or counselor says, "Tell me how bad it was”I'm gross ----- I am innocent, he was gross, or she was gross (the perpetrator)I can't remember the details so I'm probably making it up ------ My body knows the truth, I can trust my feelingsI'm totally alone ------ I am not alone anymore, counselor says, "You are not alone"No one will ever love me ------ There is love all around me, I am love, counselor can say, “You are so lovable”I feel nothing/numb about it ------ It's safe to feel, counselor can say, “You don’t have to feel anything,” or, “Sometimes people who feel nothing are actually pissed off” Who cares? ------ Counselor says, "I care! I really care!” I'm exaggerating ------ I got hurt, it hurtsIt wasn't that bad ------ I got hurt, it hurtsI can’t trust anyone ------ Some people are trustworthy, counselor says, “You couldn’t trust your abuser but you can trust me”I’ll never be safe ------ Counselor says, “In this moment, you are safe”Men are unsafe ------ Counselor says, “Some men remind you of your abuser”Women are unsafe ------ Counselor says, “Some women must remind you of your abuser”There’s something horribly wrong with me ------ Counselor says, “All the abuse in the world could not touch how good you are”I can’t keep myself safe ------ Counselor says, “You can trust your body, your body knows what is safe.”

The Importance of Anger

Survivors of abuse often have a hard time getting angry because it was not safe to show any anger or resistance during the abuse or after or ever. They found they got hurt much worse if they had a reaction or put up a fight. So when your client can express some anger, it is an important step towards breaking the silence and the powerlessness. Also, many times people got abused in a context where the abuser was acting angry so in the present, when the survivor starts to feel or express anger, they feel like they are being like their abuser. It’s very helpful to reassure the client that they have every right to get angry and that it is not hurting anyone.

The client can say these phrases while possibly (if it feels right) hitting pillows at the same time. The counselor can encourage the client to express healthy anger and rage by staying close and saying “yes!”

The counselor can also say contradictions or punch pillows while standing up for the client, showing his or her outrage at what happened to this client. The client can shake, cry, or release other feelings while watching this. Seeing someone stand up for you can be as powerful as doing it yourself.

The counselor can encourage and support anger sometimes by using the power of understatement, having the client say something like:

Sometimes rape/violation kind of makes me madOr the counselor can say, “Sometimes when people get raped/violated, there is a little bit of anger.”

When the client hears the underplay of the idea of anger, he or she might start to shake or laugh at the idea of it. The smaller mention of anger can help move the feelings along.

The Counselor as a Safe Person

When abuse survivors are given attention, there is a deep need to have the sense of un-safety and aloneness validated and contradicted. The counselor can validate the client’s experience by saying "Of course you don't feel safe." "Don't trust me until you feel safe with me!" "You don't trust me because you don't know me yet, take your time, I have to show you that I am safe." “You have to be the one to decide if I am safe.” “What do you notice, do you feel safe with me?” “Why or why not?” "How will you know when you are safe?” “What makes you feel safe?" "It must be tiring to always have to be so vigilant, what would feel safe to you, so you could let down your guard?" The burden of proof is on the counselor, not the client. The counselor needs to get their own sessions on what it feels like to not be trusted, so that they can be open, loving and present with the whole issue. If they take it personally and get triggered because someone doesn't trust them, then just covering that over with "trust me!" is not going to work. When would it make sense for the client to work on trust? When s/he begins to feel safe! Just telling a survivor that they are safe can be a good contradiction, but it can miss a treasure trove of material. The counselor must consider the whole assumption of trust. The survivor, who persistently doesn't feel safe with you, might need a different approach. Recognizing that people have not been safe so they learned not to trust, and that in some fundamental ways mistrust was part of getting safe, is important. Counselors can stay curious without assumptions by asking questions, like, "Tell me about a time you felt safe and it was true that you were." Or, "Tell me about a time that someone told you that you were safe, and you weren't." Or, "Tell me about the kinds of things that make you feel safe and the things that make you feel unsafe." “How will you know when you are safe?” Empowering the client is more important than making him or her see you as safe. If you as the counselor can stay open and curious, you can help the client explore his or her needs, boundaries, and intuition in regard to building trust.

Though I am hoping this is obvious to all counselors, it is not ok to try to date your client or send them sexual energy. This is imperative with survivors of sexual abuse even if they get confused (especially if they get confused). Many survivors have sexual feelings come up as they explore old memories and feelings and having a loving person witness them can bring that up even more. Crossing a sexual boundary would be a violation on many levels and confirm the terror that person is working so hard to heal. If you as a counselor get confused about your feelings and/or boundaries, then you need to get a session with someone else about this issue until you feel clear. If you are unable to get clear then it is best you do not counsel this client anymore.

In Closing

There is so much more that could be said about how to support a survivor of sexual abuse. There are boatloads of information on Post Traumatic Stress Disorder as well as trauma in general. Though it is great to get educated, it is ok to learn through the experience of becoming a good counselor. Listen to your client and ask for feedback. Ask what you could be doing or saying that could be helpful. Let yourself learn, make mistakes and try again. Don’t hold back because the discouraged side of the survivor already expects people to be overly careful and to be afraid to really engage. He/she expects you to pull away and stop trying. He/she expects you to give up connection because the intensity is too much. If you hang in there and don’t get distant or timid, you will be providing a great contradiction.

One thing I have seen over and over is that survivors of trauma are remarkable people. They are resourceful, creative, smart, courageous, and full of mystery. This is because they had to grow so fast and furiously in order to survive. If they have survived, it is because they are remarkable. Becoming an ally and a good counselor for abuse and trauma is worth it…for you…for them…and for the planet.